IAS 2021 Nominations Form for IAS Board Positions

Please use this form to declare your intent to be considered for an IAS Board position for the 2022 IAS Board. We are currently seeking a Member-At-Large position. You must be an active IAS member to be considered for this role

Name*

Date Submitted*

E-mail address*

Please fill out a valid email address where you can be reached if you are selected.

Current Institution of Work

Highest Educational Degree Obtained

Male/Female*

Select

Area of Work*

Select

Home Region*

Please check off the IEEE region where you currently reside

Select

IEEE Member Number*

IEEE Member Grade*

Member

Candidate Intention*

Please indicate here why you feel that you are right for the member-at-large position on the IAS Board.

Volunteer History*

Please indicate here any past volunteer history with IAS

File Attachments

Please upload your photo (.jpg or .png files preferred) and a short bio of your volunteer accomplishments. You may upload more than one file.

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